Experience with telemedicine among rheumatology clinicians during the COVID-19 pandemic: an international survey

Eugenia Yupei Chock¹, Michael Putman², Richard Conway³, Maria I Danila⁴, Bimba Hoyer⁵, Evelyn Hsieh^{1

6}, Arundathi Jayatilleke⁷, Adam Kilian⁸, Jan Leipe⁹, Jean W Liew¹⁰, Pedro M Machado^{11

12}, Philip C Robinson¹³, Namrata Singh¹⁴, Natasha Ung¹⁵, Su-Ann Yeoh¹⁶, Zachary S Wallace¹⁷, Rebecca Grainger¹⁸, Laura C Cappelli¹⁹

Affiliations

¹ Section of Rheumatology, Allergy and Immunology, Department of Medicine, Yale School of Medicine, New Haven, CT.
² Division of Rheumatology, The Medical College of Wisconsin, Milwaukee, WI, USA.
³ Department of Rheumatology, University College Dublin, Dublin, Ireland.
⁴ Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Rheumatology and Clinical Immunology, Medical Department, University Medical Center Schleswig-Holstein, Kiel, Germany.
⁶ Section of Rheumatology, Department of Medicine, VA Connecticut Healthcare System, West Haven, CT.
⁷ Section of Rheumatology, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
⁸ Division of Rheumatology, Saint Louis University School of Medicine, St. Louis, MO, USA.
⁹ Division of Rheumatology, Department of Medicine V, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
¹⁰ Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
¹¹ Centre for Rheumatology & Department of Neuromuscular Diseases, University College London.
¹² National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
¹³ University of Queensland School of Clinical Medicine, Herston, Queensland, Australia.
¹⁴ Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA.
¹⁵ NSW Health, New South Wales, Australia.
¹⁶ Department of Rheumatology, Division of Medicine, University College London, London, UK.
¹⁷ Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
¹⁸ Department of Medicine, University of Otago, Wellington, New Zealand.
¹⁹ Division of Rheumatology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

PMID: 35669677
PMCID: PMC9154733
DOI: 10.1093/rap/rkac039

Experience with telemedicine among rheumatology clinicians during the COVID-19 pandemic: an international survey

Eugenia Yupei Chock et al. Rheumatol Adv Pract. 2022.

. 2022 May 12;6(2):rkac039.

doi: 10.1093/rap/rkac039. eCollection 2022.

Authors

Affiliations

¹ Section of Rheumatology, Allergy and Immunology, Department of Medicine, Yale School of Medicine, New Haven, CT.
² Division of Rheumatology, The Medical College of Wisconsin, Milwaukee, WI, USA.
³ Department of Rheumatology, University College Dublin, Dublin, Ireland.
⁴ Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Rheumatology and Clinical Immunology, Medical Department, University Medical Center Schleswig-Holstein, Kiel, Germany.
⁶ Section of Rheumatology, Department of Medicine, VA Connecticut Healthcare System, West Haven, CT.
⁷ Section of Rheumatology, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
⁸ Division of Rheumatology, Saint Louis University School of Medicine, St. Louis, MO, USA.
⁹ Division of Rheumatology, Department of Medicine V, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
¹⁰ Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
¹¹ Centre for Rheumatology & Department of Neuromuscular Diseases, University College London.
¹² National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
¹³ University of Queensland School of Clinical Medicine, Herston, Queensland, Australia.
¹⁴ Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA.
¹⁵ NSW Health, New South Wales, Australia.
¹⁶ Department of Rheumatology, Division of Medicine, University College London, London, UK.
¹⁷ Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
¹⁸ Department of Medicine, University of Otago, Wellington, New Zealand.
¹⁹ Division of Rheumatology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

PMID: 35669677
PMCID: PMC9154733
DOI: 10.1093/rap/rkac039

Abstract

Objective: The aim was to assess rheumatology clinicians' perceptions of telemedicine and their experiences before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: We conducted a cross-sectional online survey and collected responses from rheumatology clinicians worldwide, between November 2020 and February 2021, regarding use and perceptions of telemedicine in rheumatology. We summarized data with descriptive statistics and qualitative analysis for free-text responses.

Results: The survey was completed by 349 rheumatology clinicians from 49 countries; 59% were female and about two-thirds were in the 30-50 years age group. Academic affiliations were held by 55% of participants, and 44% were from North America. Before the pandemic, 24% of participants had experience with telemedicine, whereas about three-quarters used telemedicine for the first time during the pandemic. Overall, 56% thought they provided less adequate care with telemedicine. More than half of clinicians felt that telemedicine was adequate for evaluating crystalline arthritis, inflammatory arthritis and lupus flares. Telemedicine was felt to be inadequate for flares of myositis, vasculitis and scleroderma. Technical problems were reported in 29% of telemedicine encounters and were most commonly related to patient-encountered difficulties.

Conclusion: Most rheumatology clinicians used telemedicine for the first time during the pandemic. The quality of care provided was thought to be inferior to that provided in person for specific clinical situations. Additional efforts are needed to address barriers to effective telemedicine, such as patient-related technology issues, challenges with building rapport and performing a physical examination, and to define the appropriate scope of clinical scenarios conducive to telemedicine.

Keywords: clinical practice; telemedicine.

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Figures

<sc>Fig</sc>. 1 — **Fig. 1**
Flow chart of survey patients

<sc>Fig</sc>. 2 — **Fig. 2**
Perceived adequacy of telemedicine visits for new and follow-up visits

<sc>Fig</sc>. 3 — **Fig. 3**
Perceptions of factors affecting clinical care and success of telemedicine

See this image and copyright information in PMC

References

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Experience with telemedicine among rheumatology clinicians during the COVID-19 pandemic: an international survey

Affiliations

Experience with telemedicine among rheumatology clinicians during the COVID-19 pandemic: an international survey

Authors

Affiliations

Abstract

Figures

References

LinkOut - more resources

Full Text Sources